A Review of Selected Noncontact Anterior Cruciate Ligament Injuries in the National Football League

Abstract

During five football seasons, from 1989 through 1993, 61 surgically proven, noncontact, anterior cruciate ligament injuries, were identified from among 22 National Football League teams. The variables of surface, shoe type, playing conditions, and whether or not the shoe was spatted were identified for each reported injury. Forty noncontact injuries occurred in conventional cleated shoes on natural grass, and 21 occurred on an artificial surface. Almost half of all injuries (47.5%) occurred during game-day exposures despite the fact that the practice versus game-day exposure rate was 5:1. Of these injuries, 95.2% (N = 58) occurred on a dry field. The factors of cleat and shoe type, type of surface (natural versus artificial), surface conditions (wet/dry), and the effect of "spatting" a shoe are presented. The significance of these factors and their likelihood to be associated with injury is analyzed by use of a statistical tool, the incidence density ratio.

Risk of Anterior Cruciate Ligament Injury in Athletes on Synthetic Playing Surfaces

“…Many of these factors are not modifiable, and other potentially modifiable factors, such as shoe type or quality of field, are either difficult to study or difficult to precisely quantify. An ideal study would incorporate all these factors simultaneously to determine their 17 No effect seen on anterior cruciate ligament findings --Powell and Schootman 27 ---Scranton et al 28 No effect seen on anterior cruciate ligament findings -- interaction and significance, but such a study would be prohibitively difficult to both conduct and interpret. These same issues were encountered even when examining the narrow question of whether the apparent changes of shoe-surface interaction on artificial turf lead to an increased incidence of ACL injuries.…”

Torsional injuries of the lower limb: an analysis of the frictional torque between different types of football turf and the shoe outsole

“…Dry weather conditions were associated with more non-contact ACL injuries than rain 24 26. It was hypothesised that the frictional torque of dry sports surfaces was higher compared to that of wet surfaces and therefore torsional injuries were more likely to occur 24 26. No data concerning the influence of weather conditions in soccer were found.…”

Tibiofemoral Alignment: Contributing Factors to Noncontact Anterior Cruciate Ligament Injury

“…Theories have proposed various contributors to or risk factors for injury: intrinsic [1][2][3][4] and extrinsic 1,[4][5][6] entities; the antagonist-agonist relationships 7,8 ; quadriceps contraction 4 ; and, more recently, axial compressive forces on the lateral aspect of the joint [9][10][11][12] . Initial reports on mechanisms of anterior cruciate ligament injury were based on interviews with the athletes or descriptive analyses of videotapes 1,5,13 .…”